Provider Demographics
NPI:1609210301
Name:NODA-VILA, MARIA CELIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CELIA
Last Name:NODA-VILA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 SW 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3811
Mailing Address - Country:US
Mailing Address - Phone:305-790-4491
Mailing Address - Fax:
Practice Address - Street 1:704 SW 60TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3811
Practice Address - Country:US
Practice Address - Phone:305-790-4491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13589122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist